Advertisement
Functional Outcomes After Treatment for Prostate Cancer

Functional Outcomes After Treatment for Prostate Cancer

Studies have shown that patients with localized prostate cancer have favorable long-term overall survival rates and cancer-specific survival regardless of the treatment that is selected. Few prospective, randomized trials have looked at differences in survival outcomes between radical prostatectomy and external-beam radiation therapy. As a result, the decision-making process for clinicians and patients shifts. Treatment decisions become more about predicting functional outcome than about survival. Investigations with short-term and intermediate follow-up have identified incremental differences in functional outcome between patients undergoing prostatectomy and those receiving radiotherapy. While much is known about what happens the first several years after treatment, less is known about outcomes extending beyond 5 years. “Most patients live 10 to 20 years after treatment,” says David F. Penson, MD, MPH. “A careful evaluation of long-term functional outcomes can help us better understand the experience of men living with a diagnosis of prostate cancer.” Long-Term Function of Prostatectomy Vs Radiotherapy In a study published in the New England Journal of Medicine, Dr. Penson and colleagues prospectively compared urinary, sexual, and bowel function in 1,655 men with clinically localized prostate cancer, 1,164 of whom underwent prostatectomy, while 491 received radiotherapy. The study team also examined the extent to which men were bothered by declines in function at 15 years after prostatectomy or radiotherapy. Most of the men were in their 60s when they first received treatment. According to the results, men receiving prostatectomy were significantly more likely than those in the radiotherapy group to report urinary leakage and erectile dysfunction at 2 and 5 years after treatment. However, these problems increased in both groups over time, including 15...

HIV & Injection Drug Use: Trends & Learning Lessons

While there has been a measurable decline in the number of new HIV cases throughout the United States, pockets of newly-infection people continue to persist, especially in high-risk groups. Injecting drug users (IDUs) are among those that are at increased risk for acquiring HIV because of their drug use practices and sexual behaviors. Further complicating matters is that a substantial number of IDUs are living in major urban areas where HIV prevalence is already documented to be high; many of them may also be unaware of their HIV-infection status. Since 2004, the CDC’s National HIV Behavioral Surveillance System (NHBS) has monitored disease-associated behaviors among groups considered at high risk for acquiring the virus, including IDUs. In the 2009 IDU cycle, HIV testing was also conducted to provide the first IDU prevalence data in over a decade. During 1993-1997, results from a different CDC survey found prevalence of HIV among IDUs who entered drug treatment centers in the U.S. ranged from 1% to 37%; the overall prevalence was 18%. In the March 2, 2012 Morbidity and Mortality Weekly Report, new data was released on information from 10,073 IDUs from 20 cities in 2009; 9% tested positive for HIV. Troubling New Trends in HIV Although the number of HIV infections among IDUs dropped by half over the past decade, the NHBS data showed that testing rates for the virus also decreased. The CDC recommends individuals at high risk get tested for HIV at least annually, but only 49% of IDUs who were interviewed in 2009 reported being tested in the last year. Only 19% reported participating in an HIV behavioral intervention....
Statement Addresses Sexual Activity in CVD Patients

Statement Addresses Sexual Activity in CVD Patients

A scientific statement from the American Heart Association, available for free at http://circ.ahajournals.org, indicates that sexual activity appears to be safe for most cardiovascular disease (CVD) patients. The statement recommends appropriate, individualized counseling for both women and men with CVD, depending on their health status. Full Position Statement: Circulation, January 19,...
Live Meetings Sway MDs to Screen for HSDD

Live Meetings Sway MDs to Screen for HSDD

After a series of live continuing medical education (CME) activities on female hypoactive sexual desire disorder (HSDD), primary care clinicians who previously did not screen for the disorder indicated they would incorporate such screening into their practices, according to a new study from Pri-Med. Prior to the activities, 41% of primary care clinicians did not screen for sexual dysfunction in female patients, and almost 75% reported they “sometimes/rarely/never” assessed their sexual health. However, following the activity, 61% of clinicians indicated they planned to regularly assess sexual health in their female patients, and 63% of clinicians reported they would incorporate open-ended patient questioning about sexual health into their practice. Pri-Med, a leading provider of professional medical education solutions to a community of more than 248,000 U.S.-based primary care clinicians, announced the study findings at the American College of Obstetricians and Gynecology 59th Annual Clinical Meeting, held April 30-May 4, 2011 in Washington, D.C. The live activities utilized a blend of multimedia delivery formats, including patient-physician video scenarios and interactive audience polling, to address the clinical care gaps. More than 3,100 clinicians participated in the activities in five major U.S. cities. The education intervention was sponsored and administered by pmiCME, LLC, Pri-Med’s accredited provider of education for medical, pharmacy, and nursing professionals. The content was created in collaboration with Athena Education Group, LLC, a recognized medical education company with expertise educating on women’s health issues. HSDD is an underrecognized and undertreated condition that is often overlooked by HCPs. (Frank 2008)  Women with HSDD currently receive inadequate health care in part because training in sexual medicine is absent and inadequate in most medical schools. ...
[ HIDE/SHOW ]